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일 중 수술시간이 다른 편도절제술에서 Adenosine 정주가 술 중 Remifentanil 요구량과 수술 후 통증에 미치는 영향

The Effects of Intravenous Adenosine Infusion on Intraoperative Remifentanil Requirements and Postoperative Pain in Elective Tonsillectomies Are Influenced by the Time of Day the Operation Is Performed

  • 이철 (원광대학교 의과대학 마취통증의학교실) ;
  • 이규창 (건국대학교 의학전문대학원 충주병원 마취통증의학교실) ;
  • 김혜영 (건국대학교 의학전문대학원 충주병원 마취통증의학교실) ;
  • 반종민 (건국대학교 의학전문대학원 충주병원 마취통증의학교실) ;
  • 최은경 (건국대학교 의학전문대학원 충주병원 마취통증의학교실) ;
  • 이명종 (건국대학교 의학전문대학원 충주병원 마취통증의학교실)
  • Lee, Cheol (Department of Anesthesiology and Pain Medicine, College of Medicine, Wonkwang University) ;
  • Lee, Kyu Chang (Department of Anesthesiology and Pain Medicine, Chungju Hospital, School of Medicine, Konkuk University) ;
  • Kim, Hye Young (Department of Anesthesiology and Pain Medicine, Chungju Hospital, School of Medicine, Konkuk University) ;
  • Bahn, Jong Min (Department of Anesthesiology and Pain Medicine, Chungju Hospital, School of Medicine, Konkuk University) ;
  • Choi, Eun Kyung (Department of Anesthesiology and Pain Medicine, Chungju Hospital, School of Medicine, Konkuk University) ;
  • Lee, Myeong Jong (Department of Anesthesiology and Pain Medicine, Chungju Hospital, School of Medicine, Konkuk University)
  • 투고 : 2009.05.21
  • 심사 : 2009.07.22
  • 발행 : 2009.08.01

초록

Background: The chronobiology of postoperative pain is an interesting topic. This study was performed to evaluate the effects of adenosine on inta-operative remifentanil requirements and on postoperative pain in patients undergoing tonsillectomies and how those effects change with changing time of day the surgery is performed. Methods: For this study, 120 patients were randomly allocated into four groups. Patients in groups B and D received adenosine at a dose of $50{\mu}g/kg/min$, and those in group A and C received an equal volume of saline from 10 minutes after the induction of anesthesia until the end of surgery. Group A (saline) and B (adenosine) patients entered the operating room after 08:30 and finished before 11:00, Group C (saline) and D (adenosine) patients entered the operating room after 13:30 and finished before 16:00. We evaluated the intraoperative time-weighted mean remifentanil dose, and postoperative pain scores at 1, 6, 12, and 24 hours, and the analgesic dose required during the following 24 hours. Results: Time-weighted mean remifentanil doses during the intraoperative period and the analgesic requirement during the following 24 hours in group D was significantly lower than in the other groups. The numeric rating scale for pain at 1, and 6 hours in group D was significantly lower (P < 0.01) than that of group A. There were no significant differences in side effects among groups. Conclusions: Use of intraoperative adenosine infusion provides perioperative analgesia. Postoperative pain is affected by the time of day the operation is performed.

키워드

참고문헌

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